Dispensing doctor : an underutilise resource?

Introduction Multidisciplinary models of organising and providing care have been proposed to decrease the health services gap between urban and rural populations but health workforce shortages exist across most professions and are further exacerbated by maldistribution. Flexibility and expansion of the range of tasks that a health professional can undertake were proposed. Dispensing doctors (DDs) are such an example. As part of DDs’ routine medical practice, DDs are able to both prescribe and dispense medicines to their patients. The granting of a dispensing licence to a doctor is intended to improve rural community access to medicines where there is no pharmacy within a reasonable distance. Method An iterative, qualitative descriptive methodology was used to identify factors which influenced DDs’ practice. Qualitative data were collected by in-depth face-to-face and telephone interviews with DDs. A combination of processes: qualitative content analysis and constant comparison were used to analyse the interview transcripts thematically. Member checking and separate coding were utilised to ensure rigour. Result Thirty-one interviews were conducted. The respondents universally acknowledged that the main reason for dispensing were for the convenience and benefits of their patients and to ensure continuity of care. DDs’ communities were generally more isolated and smaller when compared to their non-dispensing counterparts. DD-respondents viewed their dispensary as a service to the community. Peer pressure on prescribing was a key factors in self-regulating prescribing and dispensing. Conclusion DDs fulfill an important area of unmet needs by providing continuity of pharmaceutical care but the practice is hindered by significant barriers

An extensible framework for analysing resource behaviour using event logs

Business processes depend on human resources and managers must regularly evaluate the performance of their employees based on a number of measures, some of which are subjective in nature. As modern organisations use information systems to automate their business processes and record information about processes’ executions in event logs, it now becomes possible to get objective information about resource behaviours by analysing data recorded in event logs. We present an extensible framework for extracting knowledge from event logs about the behaviour of a human resource and for analysing the dynamics of this behaviour over time. The framework is fully automated and implements a predefined set of behavioural indicators for human resources. It also provides a means for organisations to define their own behavioural indicators, using the conventional Structured Query Language, and a means to analyse the dynamics of these indicators. The framework's applicability is demonstrated using an event log from a German bank.

The environmental enigma : why do producers professing stewardship continue to practice poor natural resource management?

Despite a wide acceptance that primary producers in Australia subscribe to a stewardship ethic, land and water degradation remains an ongoing problem. Recent calculations suggest that the economic cost of Australia's environmental degradation is amounting to more than $A3.5 billion a year with an estimated cost of managing (not overcoming) problems of salinity, acidification, soil erosion totalling $A60 billion over the next decade. This paper argues that stewardship itself is an unsatisfactory concept when looking to landholders to respond to environmental problems, for rarely does the attitude of stewardship translate into behaviours of improving natural resource management practices on private land. Whilst there is some acceptance of the environmental problem among primary producers, a number of external constraints may also impede the uptake of conservation-orientated practices. In light of the prevailing accounts of poor adoption of sustainable practices a number of policy options are reviewed in this paper, including formal regional partnerships, regulatory frameworks and market-based measures. It is concluded that the contentious nature of some of these new opportunities for change will mean that any moves aimed at reversing environmental degradation in Australia will be slow.

Genuine community engagement in remote dryland regions : natural resource management in Lake Eyre Basin

Remote dryland regions are characterised by sparse populations and socially marginalised voices which pose particular challenges to natural resource management. This paper considers the issue of how to achieve community engagement in regions with these characteristics. In doing so, the paper contributes to an expanding international research agenda focusing on the distinct characteristics of arid and semi-arid regions under the heading of 'dryland syndrome'. The paper draws on government liaison officer and local community perspectives of successful engagement in the case-study region of Lake Eyre Basin, Australia. The results demonstrate that widely recognised characteristics of successful engagement are required but insufficient for genuine engagement in remote dryland regions. In addition to building trust through community ownership, being inclusive, effective communication, and adequate resources, genuine community engagement in drylands also requires respecting the extreme conditions and extraordinary variability of these areas. Residents of dryland regions seek genuine engagement yet engage opportunistically when seasons are conducive and when tangible outcomes are visible. © 2011 The Authors. Geographical Research © 2011 Institute of Australian Geographers.

Terms of engagement : consensus or control in remote Australian resource management?

Public engagement is a defining feature of collaborative approaches to environmental management (Petts 2006, Whelan and Oliver 2005). Public engagement in this context is focused on incorporating residents and communities of interest in activities like ecological restoration, catchment management, and environmental conservation in a wide range of situations (Nelson and Pettit 2004, Petts 2007). Some authors consider public engagement to be a sign of healthy democratic functioning in society (Skocpol and Fiorina 1999). Others draw attention to overcoming widely noted practical limitations of top-down mechanisms, emphasising that public engagement results in programs being implemented more effectively (Broderick 2005, Leach et al. 1999).

Advancing practice in critical care : a model of knowledge integration

Aim The aim of this paper was to discuss the potential development of a conceptual model of knowledge integration pertinent to critical care nursing practice. A review of the literature identified that reflective practice appeared to be at the forefront of professional development. Background It could be argued that advancing practice in critical care has been superseded by the advanced practice agenda. Some would suggest that advancing practice is focused on the core attributes of an individual’s practice, which then leads onto advanced practice status. However, advancing practice is more of a process than identifiable skills and as such is often negated when viewing the development of practitioners to the advanced practice level. For example, practice development initiatives can be seen as advancing practice for the masses, which ensures that practitioners are following the same level and practice of care. The question here is, are they developing individually? Relevance to clinical practice What this paper presents is that reflection may not be best suited to advancing practice if the individual practitioner does not have a sound knowledge base both theoretically and experientially. The knowledge integration model presented in this study uses multiple learning strategies that are focused in practice to develop practice, e.g. the use of work-based learning and clinical supervision. To demonstrate the models application, an exemplar of an issue from practice shows its relevance from a practical perspective. Conclusions In conclusion, further knowledge acquisition and its relationship with previously held theory and experience will enable individual practitioners to advance their own practice as well as being a resource for others.

Space as a resource in creative design practices

Based on longitudinal ethnographic fieldwork in two industrial design departments and two design companies, we explore the role of spatial arrangements for supporting creative design practices within different design studios. From our results, we show that designers explicitly make use of the physical space for: 1) communicating and inspiring design ideas; 2) exploring design solutions, and; 3) managing design projects. We believe that these design practices could bring insightful implications for developing ubiquitous technologies to support the design profession.

Workplace surfaces as resource for social interactions

Space and spatial arrangements play an important role in our everyday social interactions. The way we use and manage our surrounding space is not coincidental, on the contrary, it reflects the way we think, plan and act. Within collaborative contexts, its ability to support social activities makes space an important component of human cognition in the post-cognitive era. As technology designers, we can learn a lot by rigorously understanding the role of space for the purpose of designing collaborative systems. In this paper, we describe an ethnographic study on the use of workplace surfaces in design studios. We introduce the idea of artful surfaces. Artful surfaces are full of informative, inspirational and creative artefacts that help designers accomplish their everyday design practices. The way these surfaces are created and used could provide information about how designers work. Using examples from our fieldwork, we show that artful surfaces have both functional and inspirational characteristics. We indentify four types of artful surfaces: personal, shared, project-specific and live surfaces. We believe that a greater insight into how these artful surfaces are created and used could lead to better design of novel display technologies to support designers’ everyday work.

Factor Five : Transforming the Global Economy through 80% Improvements in Resource Productivity

The 21st century will see monumental change. Either the human race will use its knowledge and skills and change the way it interacts with the environment, or the environment will change the way it interacts with its inhabitants. In the first case, the focus of this book, we would see our sophisticated understanding in areas such as physics, chemistry, engineering, biology, planning, commerce, business and governance accumulated over the last 1,000 years brought to bear on the challenge of dramatically reducing our pressure on the environment. The second case however is the opposite scenario, involving the decline of the planet’s ecosystems until they reach thresholds where recovery is not possible, and following which we have no idea what happens. For instance, if we fail to respond to Sir Nicolas Stern’s call to meet appropriate stabilisation trajectories for greenhouse gas emissions, and we allow the average temperature of our planets surface to increase by 4-6 degrees Celsius, we will see staggering changes to our environment, including rapidly rising sea level, withering crops, diminishing water reserves, drought, cyclones, floods… allowing this to happen will be the failure of our species, and those that survive will have a deadly legacy. In this update to the 1997 International Best Seller, Factor Four, Ernst von Weizsäcker again leads a team to present a compelling case for sector wide advances that can deliver significant resource productivity improvements over the coming century. The purpose of this book is to inspire hope and to then inform meaningful action in the coming decades to respond to the greatest challenge our species has ever faced – that of living in harmony with our planet and its other inhabitants.

Carbon, biodiversity and regional natural resource planning : towards high impact next generation plans

Given the increased importance of adaptation debates in global climate negotiations, pressure to achieve biodiversity, food and water security through managed landscape-scale adaptation will likely increase across the globe over the coming decade. In parallel, emerging market-based, terrestrial greenhouse gas abatement programs present a real opportunity to secure such adaptation to climate change through enhanced landscape resilience. Australia has an opportunity to take advantage of such programs through regional planning aspects of its governance arrangements for NRM. This paper explores necessary reforms to Australia's regional NRM planning systems to ensure that they will be better able to direct the nation's emerging GGA programs to secure enhanced landscape adaptation. © 2013 Planning Institute Australia.

Collaborative resource development for energy efficiency education

BACKGROUND There is a growing volume of open source ‘education material’ on energy efficiency now available however the Australian government has identified a need to increase the use of such materials in undergraduate engineering education. Furthermore, there is a reported need to rapidly equip engineering graduates with the capabilities in conducting energy efficiency assessments, to improve energy performance across major sectors of the economy. In January 2013, building on several years of preparatory action-research initiatives, the former Department of Industry, Innovation, Climate Change, Science, Research and Tertiary Education (DIICCSRTE) offered $600,000 to develop resources for energy efficiency related graduate attributes, targeting Engineers Australia college disciplines, accreditation requirements and opportunities to address such requirements. PURPOSE This paper discusses a $430,000 successful bid by a university consortium led by QUT and including RMIT, UA, UOW, and VU, to design and pilot several innovative, targeted open-source resources for curriculum renewal related to energy efficiency assessments, in Australian engineering programs (2013-2014), including ‘flat-pack’, ‘media-bites’, ‘virtual reality’ and ‘deep dive’ case study initiatives. DESIGN/ METHOD The paper draws on literature review and lessons learned by the consortium partners in resource development over the last several years to discuss methods for selecting key graduate attributes and providing targeted resources, supporting materials, and innovative delivery options to assist universities deliver knowledge and skills to develop such attributes. This includes strategic industry and key stakeholders engagement. The paper also discusses processes for piloting, validating, peer reviewing, and refining these resources using a rigorous and repeatable approach to engaging with academic and industry colleagues. RESULTS The paper provides an example of innovation in resource development through an engagement strategy that takes advantage of existing networks, initiatives, and funding arrangements, while informing program accreditation requirements, to produce a cost-effective plan for rapid integration of energy efficiency within education. By the conference, stakeholder workshops will be complete. Resources will be in the process of being drafted, building on findings from the stakeholder engagement workshops. Reporting on this project “in progress” provides a significant opportunity to share lessons learned and take on board feedback and input. CONCLUSIONS This paper provides a useful reference document for others considering significant resource development in a consortium approach, summarising benefits and challenges. The paper also provides a basis for documenting the second half of the project, which comprises piloting resources and producing a ‘good practice guide’ for energy efficiency related curriculum renewal.

Loss of epithelial markers and acquisition of vimentin expression in adriamycin- and vinblastine-resistant human breast cancer cell lines

We have previously observed that breast cancer cell lines could exhibit either epithelial or fibroblastic phenotypes as reflected by their morphologies and intermediate filament protein expression (C. L. Sommers, D. Walker-Jones, S. E. Heckford, P. Worland, E. Valverius, R. Clark, M. Stampfer, and E. P. Gelmann, Cancer Res., 49: 4258-4263, 1989). Fibroblastoid, vimentin-expressing breast cancer cell lines are more invasive in vitro and in vivo (E. W. Thompson, S. Paik, N. Brunner, C. L. Sommers, G. Zugmaier, R. Clarke, T. B. Shima, J. Torri, S. Donahue, M. E. Lippman, G. R. Martin, and R. B. Dickson, J. Cell. Physiol., 150: 534-544, 1992). We hypothesized that a breast cancer cell with an epithelial phenotype could undergo a transition to a fibroblastic phenotype, possibly resulting in more invasive capacity. We now show that two Adriamycin-resistant MCF-7 cell lines and a vinblastine-resistant ZR-75-B cell line have undergone such a transition. Adriamycin-resistant MCF-7 cells express vimentin, have diminished keratin 19 expression, have lost cell adhesion molecule uvomorulin expression, and have reduced formation of desmosomes and tight junctions as determined by reduced immunodetection of their components desmoplakins I and II and zonula occludens (ZO)-1. Other MCF-7 cell lines selected for resistance to vinblastine and to Adriamycin and verapamil did not have these characteristics, indicating that drug selection does not invariably cause these phenotypic changes. In addition, to determine if vimentin expression in MCF-7 cells alone could manifest a fibroblastic phenotype, we transfected the full-length human vimentin complementary DNA into MCF-7 cells. Although vimentin expression was achieved in MCF-7 cells, it did not affect the phenotype of the cells in terms of the distribution of keratins, desmoplakins I and II, ZO-1, or uvomorulin or in terms of in vitro invasiveness. We conclude that vimentin expression is a marker for a fibroblastic and invasive phenotype in breast cancer cells but does not by itself give rise to this phenotype.

Smart resource control in distribution network to improve the integration level of PV

This project was an innovative approach in developing smart coordination of available energy resources to improve the integration level of PV in distribution network. Voltage and loading issues are considered as the main concerns for future electricity grid which need to be avoided using such resources. A distributed control structure was proposed for the resources in distribution network to avoid noted power quality issues.

Acquisition of estrogen independence and antiestrogen resistance in breast cancer : association with the invasive and metastatic phenotype

A significant percentage of human breast cancer (HBC) is dependent upon the ovarian hormone estrogen for its onset and progression. The presence or lack of estrogen receptors (ERs) in human breast cancer is an important determinant both of prognosis and of choice of treatment - a poorer prognosis being associated with ER–ve disease. Cell lines established from human breast cancer provide models for breast cancer in various stages of progression (Engel & Young 1978). When grown as tumors in athymic nude mice, these lines represent the major in vivo experimental model for HBC studies (Brünner et al 1987). The ease of both in vitro and in vivo maintenance, the human derivation of the tissue, and the similarities in plasma estrogen levels between ovariectomized nude mice and postmenopausal women (Seibert et al. 1983, Brünner et al. 1986), make the growth of human breast cancer cell lines in nude mice an attractive...